Reusable laproscopic retrieval mechanism and method for use

ABSTRACT

Various embodiments of a reusable surgical device for retrieving a mass during laparoscopic surgery are shown and described. The surgical device has a wand, a rod attached to the wand near the front by a disengaging connector and extending generally parallel to the wand, and a pouch or bag attached to the wand and rod. A portion of the rod is flexible for bowing out from the wand when the rod is pushed forward. The flexible portion straightens to come close to the wand when the rod is pulled backward. A bag suitable for sterilizing may be attached to the rod and wand for receiving a mass during surgery. When the rod bows out, the bag is opened. When the rod straightens, the bag is closed to form a seal. Methods of using the surgical device include attaching a bag, engaging the disengaging connector, and inserting the device through a laparoscopic sleeve for enclosure, manipulation, and retrieval of the mass. Further steps include, removing the surgical device from the body cavity, disengaging the disengaging connector, removing the bag, disposing of the mass, and sterilizing the rod, wand and/or bag.

FIELD OF THE INVENTION

This invention relates generally to internal surgery and, morespecifically, to a reusable surgical device and methods for accessingand retrieving tissue or other mass from a body cavity.

BACKGROUND OF THE INVENTION

In recent years, the applications for laparoscopic surgery have expandedto include many different procedures. A benefit of laparoscopicoperations is the relatively quick recovery period experienced bypatients, due to the small incisions that are made in the body. Theseincisions reduce the trauma and the required healing compared totraditional surgery. Laparoscopic tubes and sleeves with diameters onthe order of 10 millimeters are inserted in the body cavity. Variousinstruments and a video camera are typically directed throughlaparoscopic sleeves for performing and monitoring the surgical steps.

A particular concern in laparoscopic surgery is the transporting oftissues and other mass that are cut away or retrieved during a surgery.While moving, manipulating, or cutting up a removed mass within the bodycavity, pieces of infected or cancerous mass, blood, bile, and otherliquids may escape into the body cavity and pose infection problems orother complications. It is desirable to contain these materials in a bagor similar enclosure within the body cavity before removal to minimizethe risk of infection or other complications. It is important that thecontainment of the materials be accomplished as quickly as possible withminimal disturbance to the surgical site.

Instruments with membranes or bags have been designed in an attempt toavoid the complications associated with the removal of tissue duringlaparoscopic surgery. These devices typically fall into two categories,those that have a bag coiled around an introducing rod that must beunfurled by various maneuvers, and those that pop open a bag using aspring, wire, or other mechanism. A device that falls into the secondcategory is a pouch disclosed in Pagedas (U.S. Pat. No. 5,368,597),which utilizes a flexible rod slidably connected to a wand to create areclosable pouch. When the rod bows out, the bag is opened. When the rodstraightens, the bag is closed to form a seal.

However, the specimen retrieval instruments that are currently on themarket, especially the more practical devices, are designed for a singleuse. Not only does this create a disposal problem, but disposableinstruments are not always cost effective. In this era of costcontainment, the need often arises for reusable instruments, especiallya laparoscopic retrieval mechanism that can be sterilized and reused. Asecond failing of the current specimen retrieval instruments is thatthey are limited as to the specimen size that can be safely retrieved. Areusable instrument that can employ different size bags and allow rapidremoval and replacement of a retrieval pouch would increase surgicalefficiency. A third fault of disposable specimen retrieval instrumentsis that specimen bags are often ruptured by morcelating instruments orpressure distention against the base of the retrieval bag. A reusabledevice warrants the additional cost of heavier gage materials that canwithstand the burden of a larger mass, the rigors of morcelation, andthe stress of sterilization.

Although Pagedas (U.S. Pat. No. 5,368,597) alludes to an option whereone may slipp a sleeve styled bag onto its device, no specificembodiment is given Moreover, no mention is made of a reusable bag thatmay be sterilized.

For the foregoing reasons, there is a need for a reusable surgicaldevice, and a method of using such a device, that allows efficientaccess and retrieval of tissue or other mass from a body cavity.

SUMMARY

According to the present invention, the foregoing and other objects andadvantages are achieved by providing a reusable surgical device forsafely manipulating and retrieving tissue from a body cavity inoperations such as laparascopic surgery, and also a method for using thesurgical device. A surgical device having features of the presentinvention comprises an elongated wand having a front end and a back end,a rod having a flexible portion and a handle portion, and a removablebag. The flexible portion includes a second end attached to the handleportion, and a pivot end near the front end of the wand by a disengagingconnector. The handle portion of the rod and the back end of the areclose to each other that they can be manipulated from outside a bodycavity. Preferably the bag for enclosing and retrieving material duringsurgery is coupled to the front of the wand and the flexible portion ofthe rod. The bag may be opened by pushing the rod forward relative tothe wand to bow out the flexible portion and may be closed by pullingthe rod backward relative to the wand to straighten the flexibleportion.

Another object is to provide a surgical device that may be accuratelymanipulated and controlled with one hand.

Another object is to provide a surgical device that has an adjustableopening that seals when closed.

Another object of the invention is to provide a surgical device that maybe sterilized and reused. The reusable portions that can be sterilizedmay include the wand, the rod, and/or the bag.

Another object of the invention is to provide a surgical device thatincludes a lock that may be engaged so that a surgeon does not have tohold the device at the desired bag position. Bag positions may include adegree of openness ranging from completely dosed to wide open, dependingon the extent to which the flexible portion of the rod is bowed.

Another object of the invention is to provide a surgical device thatincludes a thumb grip to facilitate moving the flexible portion of therod.

Methods of using the surgical device comprise the steps of attaching abag to the front end of the wand and flexible portion of the rod,engaging the disengaging connector, directing the device into a bodycavity, opening the bag by pushing the rod forward to cause the flexibleportion to bow out, receiving a mass from the body cavity into the bag,and dosing the bag by pulling the rod backwards to cause the flexibleportion to straighten and form a seal against the wand. Additional stepsmay include, morcelating the removed mass, removing the surgical devicefrom the body cavity, disengaging the disengaging connector, removingthe bag, disposing of the removed mass, and sterilizing the wand, rodand/or bag for reuse.

Accordingly, the present invention provides an economical means forachieving greater efficiency, control and safety in containing materialswithin, and removing materials from, a body cavity during laparoscopicsurgery.

These and other features, aspects and advantages of the presentinvention will become better understood with regard to the followingdescription. Other objects, advantages and novel features of theinvention will become apparent to those skilled in the art. As will berealized, the invention is capable of other and different embodimentsand use in other applications, and its several details are capable ofmodification in various obvious respects, all without departing from theinvention. Accordingly, the drawings and descriptions are to be regardedas illustrative in nature and not restrictive.

DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of one embodiment of the surgical deviceshowing the bag removed from the wand and rod.

FIG. 2 is a perspective view of one embodiment of the surgical devicedepicting the bag being attached to the wand and rod.

FIG. 3 is a perspective view of one embodiment of the surgical deviceshowing the bag attached to the wand and rod.

FIG. 3A shows how one embodiment of the disengaging connector isengaged.

FIG. 4 is a perspective view of one embodiment of the surgical deviceshowing the bag in an opened position.

FIG. 5 is a perspective view of one embodiment of the surgical deviceshowing the bag in a closed position.

FIG. 5A shows how one embodiment of the disengaging connector isdisengaged.

FIG. 6 is a right side view of one embodiment of the invention in aclosed position and including an adjustable connector.

FIG. 7A is a cross-sectional view of one embodiment of the back end ofthe wand and the handle portion of the rod, as viewed along line 7--7 inFIG. 6.

FIG. 7B is a cross-sectional view of one embodiment of the back end ofthe wand and the handle of the rod, as viewed along line 7--7 in FIG. 6,illustrating a dovetail-shaped channel system.

FIG. 8 is a cross sectional view of the front end of the wand and theflexible portion of the rod, as viewed along line 8--8 in FIG. 6.

FIG. 9 is a top view of another embodiment of the invention with a bagattached and in the open position.

FIG. 10 is a cross-sectional view of one embodiment of the back end ofthe wand and the handle portion of the rod, as viewed along line 10--10in FIG. 9.

FIG. 11 is a view of one embodiment of the surgical device directedthrough a laparoscopic sleeve into a body cavity and opened for use inlaparoscopic surgery.

DETAILED DESCRIPTION

Although the disclosure hereof is detailed and exact to enable thoseskilled in the art to practice the invention, the physical embodimentsherein disclosed merely exemplify the invention which may be embodied inother specific structure. While the preferred embodiment has beendescribed, the details may be changed without departing from theinvention, which is defined by the claims.

As shown in FIG. 1, the preferred embodiment of the surgical device 11includes an elongated wand 12 with a front end 14 and a back end 16. Thewand front end 14 and back end 16 serve as reference points for thisdiscussion, so that "forward" and "front" refer to those movements orlocations toward the front end 14 and "backward" and "back" refer tothose movements toward the back end 16. The surgical device 11 furtherincludes an elongated rod 18 that has a handle portion 24 connected to aflexible portion 22. The handle portion 24 lies close and generallyparallel to the wand 12 and may be coupled to the wand 12 in somefashion. The flexible portion 22 includes a pivot end 20 and a secondend 21. The second end 21 of the flexible portion 22 is connected to thehandle portion 24, and the pivot end 20 is coupled to the wand's frontend 14 using a disengaging connector 80. The surgical device furthercomprises a removable bag 50 that may be sterilized and reused.

In the preferred embodiment a slot system serves as a connector forholding the handle portion 24 close to the back end 16 of the wand andto set the transition point 26 where the flexible portion 22 transitionsfrom lying close to the wand 12 to bowing out from the wand 12. Thistransition point 26 may be anywhere on the flexible portion 22 betweenthe pivot end 20 and the second end 21. However, designing a surgicaldevice 11 with the transition point 26 very close to the pivot end 20would give little longitudinal distance in which the flexible portioncould bow. Therefore, the connector preferably extends forward to aboutthe middle of the flexible portion 22.

As shown in FIGS. 1 and 6, the slot system includes a channel 28 and alip 32. The channel 28 extends along the longitudinal axis of the wand12 from the back end 16 and forward preferably to the correspondinglocation of the rod's pivot end 20. The rod 18 is received in thechannel 28. The lip 32 extends partially over the channel 28 forslidably holding the rod 18 in the channel 28 forward up to the locationof the front extremity 30. At the front extremity 30, the rod 18 maycome out of the channel system as illustrated in FIG. 1.

The channel 28 preferably extends all the way to the location where thepivot end 20 attaches to the front end 14, so that when the flexibleportion 22 straightens, it may be received in the channel 28 to form aseal 34 between the front end 14 and the flexible portion 22, or betweenthe first portion 160 and the second portion 162 of the bag 50. Otherdesigns may be used to allow the front end 14 and the flexible portion22 to cooperate to form a seal 34, such as the embodiment in FIGS. 9 and10 in which the front end 14 and flexible portion 22 inner surfaces 40,42 are flat.

To bow out the flexible portion 22, the surgeon pushes the handleportion 24 forward, preferably using a thumb grip 44 or some other meansthat aids comfortable operation. Because it is anchored at the pivot end20, the rod 18 responds to being pushed by bowing out. To straighten theflexible portion 22 and the bring it closer to the wand 12, the surgeonpulls the handle 24 backwards. Alternatively, the flexible portion 22may be biased in the closed or unbowed position by allowing the flexibleportion 22 to spring back to the unbowed position when pressure on thethumb grip 44 is released.

Regarding the flexibility of the wand 12, there are several options. Thewand front end 14 may be rigid in some embodiments and somewhat flexiblein other embodiments. For example, the front end 14 may be somewhatflexible for operations in which the surgeon needs to temporarily bendthe wand to reach a particular location in the body cavity 70 at aparticular angle. However, the wand 12 should be less flexible than theflexible portion 22 of the rod 18, so that the flexible portion 22 bowsout from the wand 12 when the handle portion 24 is pushed, rather thanthe flexible portion 22 and the wand front end 14 bending together inthe same direction and thus producing either no opening of the bag 50 ora partial and difficult-to-control opening.

Regarding the flexibility of the rod 18, there are also several options.The flexible portion 22 should be of a flexibility in the outwarddirection that causes it to bow out relative to the wand 12 when it ispushed. The rod 18 may have a rigid handle portion 24 which may be heldclose to the wand 12 either by the hand of the person using it or by thelaparoscopic sleeve 64. The rod 18 may also be flexible back to andincluding the handle portion 24, as long as a connector is included tohold and guide the handle portion 24 when it is being pushed and as longas the handle portion 24 flexibility is limited to a range which doesnot cause buckling and binding of the rod 8 inside the connector. Inother words, the rod 18 may have a flexible portion 22 near the pivotend 20 and a relatively rigid handle portion 24, or may be a flexiblerod with a flexible portion 22 and a flexible handle portion 24 whichcooperates with a connector that holds and guides the handle portion 24.

Optionally, embodiments with a rigid handle portion 24 may also includea connector, such as the collar 66 shown in FIGS. 1 and 7, foradditional guiding of the handle portion 24. FIG. 1 shows an example ofthe optional adjustable feature for a connector, the adjustable featurebeing for changing the longitudinal location of the connector frontextremity 30 to change the rod transition point 26. The collar 66 may bemoved forward or backward to select a transition point 26 and then maybe locked into place, for example with a set screw (not shown), in sucha way that the rod 18 may still slide through the collar. An adjustableconnector such as the collar 66 may also be added to embodiments havinga slot system, as shown in FIG. 6. With an adjustable connector, asurgeon may use a wand 12 and rod 18 with differently-sized bags or bagswith differently-shaped entryways.

The preferred materials for the wand 12 and rod 18 are any materialsthat fulfill the various flexibility and rigidity requirements whilealso being safe for sterilization and internal surgery use. Surgicalsteel could be machined to meet those needs.

In the preferred embodiment, the pivot end 20 of the flexible portion 22is attached to the front end 14 of the wand 12 by a disengagingconnector 80. Preferably, the disengaging connector 80 comprises thefront end 14 of the wand having a longitudinal slot 82 forming a firstprong 84 and a second prong 86. A first notch 94 is formed in the firstprong 84, and a second notch 96 is formed in the second prong 86. Theflexible portion 22 of the rod 18 includes a first perpendicular spur 90and an opposing second perpendicular spur 92. As shown in FIG. 3, toengage the disengaging connector 80, the first and second spurs 90, 92are pressed into the first and second notches 94, 96 respectively. Asthe handle portion 24 is pushed forward, preferably using a thumb grip44, and the flexible portion 22 bows out, spurs 90 and 92 rotate innotches 94 and 96, respectively, creating a hinge action. To disengagethe connector 80, one pops out the spurs 90, 92 from the notches 94, 96by applying pressure to the underside 88 of the connector 80 as shown inFIG. 5A.

Although the preferred embodiment includes a disengaging connector 80with a hinge action, any connector may be used to connect the front end14 to the pivot end 20 so long as the disengaging connector 80 will notdisengage under the stress necessary to bow out the flexible portion 22,yet may be efficiently disengaged to remove the bag 50 for disposal orsterilization. Other such connectors may include a snap, a slot andgroove arrangement, other notch and spur configurations, or othercomparable cooperating systems.

The preferred embodiment includes a bag 50 for enclosing a mass 52,which may be opened and closed by bowing and straightening action of theflexible portion 22. The bag 50 has a wall 54 for surrounding aninterior space 56, and an edge 38 that surrounds the entryway 58. Thebag 50 can be disposable or reusable. The preferred materials for thebag 50 should also meet sterility and safety requirements for internalsurgery. Transparent plastics, flexible fabrics, and netting could beused. The preferred materials have some memory for tending to stay in asomewhat expanded state rather than tending to collapse, because thisfeature aids in the quick opening or unwrapping of the bag 50. Thepreferred materials are impermeable to liquid or are liquid-resistant,for containing infected liquids, but netting or loosely-woven materialscould also be of benefit for some surgical procedures. Where morcelatingis necessary, a bag 50 may include a fine denier Kevlar brand or aSpectrafiber brand fiber that is puncture resistant and able towithstand the cutting of a mass.

In one embodiment having a detachable bag 50, the bag 50 includes asleeved rim 152 with at least one opening 154. In the preferredembodiment, the bag 50 includes a sleeved rim 152 divided into a firstpart 160 and a second part 162, each part having a first opening 164 anda second opening 166. The first part 160 and second part 162 are dividedby an unsupported section 62. The unsupported section 62 allows theflexible portion 22 to slide forward without tearing the bag 50 and toslide backward without pulling the bag 50 underneath the lip 32. Asshown in FIG. 2, to attach the bag 50, one slips the flexible portion 22into the first opening 164 of the first part 160 of the sleeved rim 152,and slips the front end 14 of the wand 12 into the first opening 164 ofthe second part 162 of the sleeved rim 152. The flexible portion 22 andthe front end 14 of the wand 12 slip through the sleeved rim 152 and outthe second opening 166 of the sleeved rim 152 at which time thedisengaging connector 80 is engaged as shown in FIG. 3 by applyingpressure to the underside 88 and topside 89 of the connector 80.

The method of using the surgical device 11 includes attaching a bag 50to the front end 14 of the wand 12 and the flexible portion 22 of therod 18, and directing the surgical device 11 into a body cavity 70,preferably through a laparoscopic sleeve 64, so that the back end 16 andhandle portion 24 are accessible by the surgeon. As shown in FIG. 4, thebag 50 is opened by pushing the handle portion 24 forward, preferablyusing a thumb grip 44. The bag 50 is directed relative to the mass 52 sothat the mass 52 moves through the entryway 58 into the interior space56 of the bag 50. This may be done by moving the bag 50 to the mass 52and scooping it up or by inserting the mass 52 into the bag 50 withanother tool 72. The bag 50 may be closed for further manipulation ofthe mass 52 or for removal of the surgical device 11 and mass 52 fromthe body cavity 70. To facilitate removal from the laparoscopic sleeve64, the bag 50 may be wrapped around the front 14 flexible portion 22 toform a compact and smooth unit.

Optionally, a grinding, cutting, or other surgical tool 72 may beinserted into the interior space 56 of the bag 50 for furthermanipulation of the mass 52, for example, to cut a large mass intopieces that will fit through the laparoscopic sleeve 64. The surgicaltool 72 may be inserted before the bag 50 is closed, or after the bag 50is closed if the flexible portion 22, front end 14, or bag 50 is adaptedto allow a surgical tool 72 to pass through the seal 34. Preferably, theflexible portion 22, front end 14, or bag 50 would also be adapted tomaintain a good seal around the inserted surgical tool 72 to preventescape of mass and liquid. Optionally, a surgical tool 72 could beinserted into the body cavity 70 through the same laparoscopic sleeve 64as the surgical device 11, or through a hollow passage in the wand 12.

The above described embodiments of this invention are merely descriptiveof its principles and are not to be limited. The scope of this inventioninstead shall be determined from the scope of the following claims,including their equivalents.

In describing the embodiments disclosed herein the inventor has alsodescribed all the various alternative structures which are equivalent toone or more elements or limitations of the claimed invention. Beyondwhat is expressly described herein the inventor has no prior knowledgeof any other structures which are equivalent to the invention claimed.Accordingly, the determination of structures, methods, or compositionsof matter which are equivalent to the claimed invention shall not belimited to only the alternative structures identified herein, but shallinclude other structures whether or not they are presently known orunknown.

What is claimed is:
 1. A surgical device comprising:an elongated wandhaving a front end and a back end; an elongated rod including a handleportion lying generally parallel to said back end of said wand, and aflexible portion having a pivot end and a second end, said second endconnected to said handle portion; a disengaging connector coupling saidfront end of said elongated wand to said pivot end of said flexibleportion; a means of slidably connecting said handle portion to said backend of said wand; a reusable bag coupled to said front end and saidflexible portion.
 2. The surgical device of claim 1 wherein said bagcomprises:a sleeve rim including at least one opening to receive saidflexible portion and said front end of said wand.
 3. The surgical deviceof claim 1 further comprising a sealing means wherein said flexibleportion of said rod and said front end of said wand cooperate to sealthe bag when said flexible portion straightens to lie dose and parallelto said front end of said wand.
 4. The surgical device of claim 1wherein said disengaging connector further comprises:said wand formedwith at least one notch; at least one spur attached to said rod andcooperating with said notch.
 5. The surgical device of claim 1 whereinsaid means of slidably connecting said handle portion to said back endof said wand further comprises:a front extremity for determining alocation where said flexible portion transitions from lying dose andparallel to said wand to bowing out from said wand when said handle ispushed forward toward said front portion of said wand.
 6. The surgicaldevice of claim 1 wherein said bag is puncture resistant.
 7. Thesurgical device of claim 1 wherein said bag is made of a fine denierfiber.
 8. The surgical device of claim 1 wherein said bag can besterilized.
 9. A surgical method for manipulating and retrieving a massfrom a body cavity, said method comprising:directing a surgical deviceinto a body cavity, said surgical device including;an elongated wandhaving a front end and a back end; an elongated rod including a handleportion lying generally parallel to said back end of said wand, and aflexible portion having a pivot end and a second end, said second endconnected to said handle portion; a disengaging connector coupling saidfront end of said elongated wand to said pivot end of said flexibleportion; a means for slidably connecting said handle portion to the backend of said wand; a bag having a wall defining an interior space, and anentryway for communication with said interior space, said bag attachedto said front end of said wand and said flexible portion of said rod;opening said entryway of said bag by pushing said handle portion of saidrod forward toward said front end of said wand so that said flexibleportion of said rod bows out from said front end of said wand; directingsaid bag relative to said mass so that said mass moves through saidentryway into said interior space of said bag; and closing said entrywayof said bag by pulling said handle of said rod backward away from saidfront end of said wand so that said flexible portion of said rodstraightens to lie close and parallel to said front end of said wand.10. The surgical method of claim 9 further comprising the steps ofattaching said bag to said wand and said flexible portion of said rod.11. The surgical method of claim 9, wherein said surgical device furthercomprises a sealing means wherein said flexible portion straightens tolie close and parallel to said front end of said wand; and wherein saidstep of closing said entryway of said bag further comprises sealing saidbag.
 12. The surgical method of claim 9 further comprising the step ofdirecting a surgical tool into said interior space of said bag aftersaid mass has moved through said entryway of said bag into said interiorspace for access to said mass.
 13. The surgical method of claim 9further comprising disengaging said disengaging connector and removingsaid bag from said wand and said flexible portion of said rod.
 14. Thesurgical method of claim 9 further comprising sterilizing said surgicaldevice and reusing said surgical device.
 15. The surgical method ofclaim 9 further comprising sterilizing said wand and said rod andreusing said wand and said rod.
 16. The surgical method of claim 9further comprising sterilizing said bag and reusing said bag.
 17. Alaparoscopic surgical device comprising:an elongated wand having a frontend and a back end; an elongated rod including a handle portion lyinggenerally parallel to said back end of said wand, and a flexible portionhaving a pivot end and a second end, said second end connected to saidhandle portion; a disengaging connector coupling said front end of saidelongated wand to said pivot end of said flexible portion, saiddisengaging connector including said wand formed with at least oneprong, said prong formed with at least one notch, and at least one spurattached to said rod and cooperating with said notch; a means ofslidably connecting said handle portion to said back end of said wand; abag attached to said front end and said flexible portion.